SONGS topping the charts in the United States can be heard coming from a sports bar and bottle store at Musami Shopping Centre in Murehwa, Mashonaland East.
People seated on shop verandahs are nodding their heads in appreciation of the cool rhythms.Opposite the sports bar is a butchery and a supermarket with nothing special, except freezits, potato crisps, maputi and 750ml bottles of cooking oil going for $45 000.While a truckload of Chibuku is being offloaded, a small boy passes by with his herd of cattle heading for the pastures.It seems to be business as usual at the business centre, but not at Nohoreka Clinic.Painted in brown, the small clinic has been favoured by locals as the best substitute to government clinics as they have proved to be of little help due to the economic hardships caused by the political crisis in the country.It is a big day for Musami people and a large crowd has gathered to witness the handover of the much-needed clinical equipment worth US$20 000 from the Australian embassy.Nohoreka Clinic, handling mainly HIV and Aids issues and other chronic diseases, has brought hope to 369 patients in the Musami area yet one person manages it —— a nurse —— Jennifer Mugano.Before Mugano was given an assortment of medical kits by the Australian embassy in a project implemented by the Community Technology Development Trust (CTDT) she had no choice but to use ordinary tools.Some of the medical kits she received included complete laryngscopes, desktop steam sterilisers, nebuliser masks, stethoscopes, vital signs monitors, double bottle suction units, mobile utility drug cabinets, digital scales and an oxygen machine.A tour around the clinic showed that a lot still was needed to meet the demands of increasing patients. Mugano said the clinic attend to an average 50 patients daily.A small wooden table that looks like an old coffee table was improvised as an examination tray.On the table are different silver jars with labels stuck on to them, for instance one was used as a speculum jar.A yellow metal tin with paint peeling from its corners was used to boil bandages as a way of sterilising them.Mugano said: “Per day I attend to between 35 to 40 HIV and Aids patients and right now three patients are admitted. There isn’t much food around to feed them, medicines to give them as well as bedding. We only have three beds and if more than three patients are admitted some have to sleep on the floor.”She said the clinic treated a maximum of five children daily who are living positively with HIV.Drugs such as multivice, Vitamin B, HCT for chronic diseases, basic pain killers and a variety of pills for HIV and Aids patients were in short supply.Mugano said the water system at the clinic was a cause of concern. With no tapped water inside the clinic, she had to improvise. She connected a pipe from an outside borehole to supply water into a tin located inside the clinic.The difficult access to water makes Mugano’s work very difficult, especially when dealing with patients suffering from diarrhoea.CTDT executive director Andrew Mushita said the clinic was a model of community health service management they were promoting.He said: “We want to transfer the management and responsibility of community health service to rural communities themselves. We want to shift the management of health systems from the government to the communities themselves.”  The International Committee of the Red Cross (ICRC) earlier this year said following assessments of health services in rural areas of Zimbabwe in 2006, it identified the need for essential drugs, medical materials and consumables (eg syringes, latex gloves) along with safe water and sanitation facilities.However, for the rural folks the biggest challenge they face is lack of money to afford good health services.Despite health fees being reasonable at most rural clinics and hospitals, the people cannot afford to raise the money. With the poor harvest they experienced in the “Mother of all Agricultural Seasons” in the 2007-2008 farming season they were left barely with anything to make them generate cash.Agnes Kanembu, who frequents Nohoreka clinic said the attitude they had these days was that if a relative fell ill they would just watch them until either they felt better or eventually passed away.She said: “There are times we just look at our loved ones and wait for a miracle to happen. It’s worse if there is no extended family with money to help. To travel to the nearest hospital we will be referred to Murehwa and we need bus fare, which is exorbitant.“The clinics demand about $15 000 for a card and to be treated you need to fork out about $25 000 depending on the state of one’s illness. It becomes worse depending on how much the drugs prescribed will cost. If the illness is serious we are forced to sell a goat and currently it is going for $3 million. What of those who don’t have livestock? They will die in their homes”Shortage of basic food besides hitting the community hard was also affecting clinics and hospitals in rural areas.“We eat bread made out of mazhanje and buns made out of a wild fruit mixed with rapoko —— this tastes like chocolate,” Kanembu said sharing a small piece of the bun with this reporter.The bun is popularly known in the area as “Mugabe wanyara” —— to them meaning Mugabe you have stretched us too far to the extent of us eating such food.Mugano said food shortage was a serious problem in the area and last month she had to deal with three children who were suffering from kwashiorkor.The World Food Programme (WFP) last week issued an appeal for additional donor funds to feed Zimbabweans.This followed a warning last month from the Famine Early Warning Networks System that Zimbabwe “could run out of cereals” by early November if the pace of imports into the country by commercial and humanitarian players did not increase threefold.Kanembu said Nyamutumbu Clinic close to her home area was also in short supply of gloves, painkillers and even staff.She said she preferred Musami Mission Hospital to Murehwa Hospital.“In Musami we are lucky that we have quite a number of donors who help us otherwise we would have been dead by now. Musami Mission Hospital might not have much to deliver, but it is better than Murehwa Hospital,” said Kanembu.HIV positive Memory Mavhunga said the biggest problem hospitals in her rural area faced was drug shortages.“Most of these hospitals do not have medicine and that is the biggest challenge for us patients. Moreover we do not have money to buy those the doctors would have prescribed,” she said.Australian ambassador to Zimbabwe John Courtney, who officiated at the handover ceremony, said his country would continue to offer humanitarian assistance despite the political tension between his government and that of Zimbabwe.“Australia has been active in development assistance in Zimbabwe since Independence. Australia is the biggest donor in humanitarian relief and we will continue in assisting Zimbabwe,” said Courtney who declined to comment on political developments in the country.MDC MP for Murehwa West, Ward Nezi, said rural health delivery service had collapsed.Nezi said: “At St Pauls Mission there is a serious shortage of drugs right from pain killers or even basic things like maternity pads. It is very sad. Some clinics do not have electricity for example Kadzere Clinic. How are people expected to work in emergency situations?“Most people do not have money to get admitted or even bus fares to travel to the hospitals. There are very few ambulances and at some hospitals if at all they have them they are there either not working or don’t have fuel. A lot of money will be needed to improve the situation. We pleaded to (David) Parirenyatwa (Minister of Health and Child Welfare) to push hard in providing the people with essential things.”Parirenyatwa pleaded with the Australian embassy to donate CD4 count machines to rural hospitals. He promised to give a greenlight to Nohereka Clinic to distribute ARVs.This week, a call was made by anti-poverty campaigners across Africa for a speedy delivery by governments of the Millennium Development Goals (MDGs) and provides affordable medicines and universal access to ARVs to those living with HIV and Aids.France earlier this month announced it would release food aid amounting to two millions euros to provide immediate support to the most vulnerable people of Zimbabwe as well as to support medium- and long-term policies aimed at promoting food security.The two-million-euro aid package will be donated through the World Food Programme, the International Federation of the Red Cross, and the French agency Action Contre La Faim.
By Wongai Zhangazha
